Abstract Background Patients with acute myeloid leukemia (AML) are still at risk of relapse after consolidation therapy with cytarabine. Therefore, early identification and intervention of patient s at high risk of relapse is crucial. Methods This single-center retrospective study analyzed the clinical data of 355 patients with AML (non-APL) who received cytarabine consolidation therapy. Key factors affecting relapse were identified by least absolute shrinkage and selection operator regression, and a predictive model for relapse after cytarabine consolidation therapy was constructed and internally validated. Results The study showed that age ≥ 50 years, female, DNMT3A mutation, TP53 mutation, IDH1 mutation, CBF-AML mutation, white blood cell (WBC) ≥ 30 × 109/L, 1-2 courses of induction therapy, 1-2 courses of cytarabine consolidation therapy and cumulative dose of cytarabine 36 g were significantly correlated with relapse after cytarabine consolidation therapy in AML patients. Constructing a nomogram using the above factors and validating it with receiver operating characteristic, calibration curves showed that it has good discrimination and prediction. Patients were categorized into high-risk and low-risk groups based on the median risk score of the model, and there were significant differences in overall survival and event-free survival between the two groups. Conclusion Predictive models based on age, sex, DNMT3A, TP53, IDH1, CBF-AML, WBC count, induction therapy course, cytarabine consolidation course, and cumulative dose can effectively assess the relapse risk after receiving cytarabine consolidation therapy in AML patients and provide a reference for clinical decision-making. Implications for practice Based on Chinese AML patients as the study base, this study identifies independent prognostic factors affecting relapse after cytarabine consolidation therapy, and proposes a predictive model to assess the risk of early relapse in AML patients after receiving cytarabine consolidation therapy. This may provide a reference for clinicians to guide personalized treatment.
Ji et al. (Thu,) studied this question.